“I wanted to complete the circle: receive and give”, explains Anabel Roman. Their son Ángel was born at 32 weeks and for the first four days of his life he was fed with donated breast milk, an option recommended by neonatologists for premature babies when breastfeeding is not possible or desired. Anabel’s milk ended up coming up, but the food her baby had thanks to an altruistic mother encouraged her to donate. Diana and the 700 donors who contribute to the breast milk bank in Catalonia did the same. In Spain there are about twenty banks that collect, process and offer human milk to hospital wards.
This chain of solidarity is essential for the health of hundreds of premature babies, as many studies support the benefits of breast milk. Neonatologists prescribe them donated human milk if mother’s milk is not possible. “It’s the best food we can offer you,” says Vall d’Hebron neonatologist Fátima Camba. It helps reduce the risk of diseases associated with prematurity such as bronchopulmonary dysplasia or retinopathy of prematurity. And it has digestive benefits as it reduces the risk of necrotizing enterocolitis. In these cases, in maternity hospitals such as the one in Vall d’Hebron, the first option is always the mother’s own milk. If not, donated “human milk” is recommended, explains Carla Balcells, neonatologist at Sant Joan de Déu. “Many mothers do not know about the benefits of breastfeeding in general and specifically in premature babies”, explains Fátima Camba.
In December 2022, Àngel was born, the son of Anabel Roman, 38 years old. She came into the world prematurely at 32 weeks due to pre-eclampsia and ruptured sac. He weighed 1.3 kg and was admitted to the ICU for four days and 18 in intermediate care. Two hours after birth, Vall d’Hebron was advised that the little one should drink donated milk. She wanted to give him her own milk, but until that was possible she knew it was the best option. There he began the circle that he would later complete. “If my son is like this, it’s thanks to the milk given,” says this preschool teacher, who is a single mother by choice. Ángel ate by tube. At four days, Anabel was able to start feeding her son with her own milk and at three weeks, with the baby weighing 1.8 kg, they went home. In March she started donating while still breastfeeding.
The neonatologists’ last recommendation is artificial milk because “the mother’s milk protects the digestive system and carries antibodies”, says hematologist Joan Ramon Grífols, director of the Blood and Tissue Bank, on which the Catalan milk bank depends. Dr. Balcells goes further and states that “formula milk harms very premature newborns (or babies) in the first weeks of life”. Also at the Madrid Regional Milk Bank, which emerged in the hospital on October 12, they give milk donated to premature babies, explains Beatriz Flores, neonatologist and quality manager.
Diana González’s son was born by caesarean section at 31 weeks with a weight of 1,270 kg. He came to the world so advanced that Biel had no name. The mother, who is 46 years old and works in the human resources department of a supermarket chain, had not yet decided whether she would breastfeed her child. The Maternity Hospital was advised that as long as she did not have milk, the best thing was to donate. She assures that this gave her “peace of mind” to be able to dedicate herself to breast stimulation. “When I got a drop, I took it to the baby”, he recalls. Biel was admitted for 35 days and fed on Diana’s milk, in addition to the donated milk. At 15 days, the mother was already producing enough milk for her son. “Gratitude” pushed her to breastfeed and also give.
In Catalonia, the first initiative to have a breast milk bank arose at the Vall d’Hebron hospital. And it has been 13 years since the bank was officially created.
Once the milk is extracted, the donor keeps it in a part of the freezer separated from the rest of the food. And notify the bank to come pick it up. There it is analyzed and subsequently undergoes a pasteurization process to avoid any pathogen. The milk is stored at -80 degrees or -20 degrees and each bottle can last from three months to a year, depending on the storage temperature, waiting to be distributed to maternity hospitals that pay for the service.
It is precisely the cost that forces hospitals to limit the indications for this milk, explains Dr. Camba de Vall d’Hebrón. As the birth rate has dropped, so have premature babies, says the neonatologist. So when the bank started, in this hospital they had about 150 prematures a year and now there are about 120. This means that if before it was planned during the first week or 15 days, now it can be given until the baby is 32 weeks if born at 24 weeks. In Vall d’Hebron they have extended indications for the benefits of this milk. “It is an added cost to use this milk for the hospital, but the benefit is global”, explains Camba, who assures that if it were not a limited resource they would give bank milk to all the babies in the unit who did not have the option of breastfeeding.
Donor mothers tend to be very well informed. The children of many of them have needed this milk and this motivates them to show solidarity. There are also cases like that of Lorena Valverde, who donated when her children started daycare because she had a lot of milk. Sometimes he delivered more than two liters. A huge amount considering that some babies start out on one or two milliliters. For a woman who has just given birth, reaching the 12 or 24 ml that an extremely premature baby can take is difficult because the extraction is demanding, even more so when the mother is tired, says Dr. Camba. That is why he believes that the support of professionals is important. “Banked milk is a good resource, but we need to help mothers so that they have their own milk,” advises Dr. Camba.
Anabel has had to stop donating because she takes medication incompatible with donating, but she continues to breastfeed and encourages other women to donate. Diana will continue to donate while breastfeeding so that other babies have a chance for Biel or Ángel.
